本文選題：肺癌　切入點(diǎn)：腫瘤相關(guān)性貧血　出處：《湖北中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的1.通過對(duì)388例住院肺癌病例進(jìn)行回顧性分析,總結(jié)肺癌相關(guān)性貧血的發(fā)病情況及治療現(xiàn)狀,為臨床治療提供參考。2.觀察健脾益腎方治療晚期非小細(xì)胞肺癌(Non-Small Cell Lung Cancer,NSCLC)相關(guān)性貧血的臨床療效,為中西醫(yī)結(jié)合治療腫瘤相關(guān)性貧血提供依據(jù)。方法1.收集2015年1月至2015年12月在湖北省中醫(yī)院腫瘤科住院的肺癌患者共388例,均經(jīng)組織病理學(xué)確診并有完整病歷資料,統(tǒng)計(jì)患者住院期間腫瘤相關(guān)性貧血的發(fā)病情況、發(fā)病特點(diǎn)及貧血治療情況。2.研究選取2016年1月至2016年9月在湖北省中醫(yī)院腫瘤科就診的晚期NSCLC合并輕、中度貧血的血虛型患者70例,利用隨機(jī)數(shù)字表法分為治療組(中西醫(yī)結(jié)合組)和對(duì)照組(單純西醫(yī)組),每組各35例。兩組患者一般情況及血紅蛋白值(Hemoglobin,Hb)經(jīng)統(tǒng)計(jì)學(xué)分析,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。對(duì)照組采取補(bǔ)充鐵劑、葉酸、維生素B12治療(多糖鐵復(fù)合物膠囊300 mg,每日1次口服;葉酸片10 mg,每日3次口服;維生素B12片25μg,每日3次口服)。治療組在對(duì)照組基礎(chǔ)上口服健脾益腎方,每日一劑,水煎至300ml,分兩次溫服,療程6周。6周后觀察兩組治療后血紅蛋白值、卡氏評(píng)分(Karnofsky,KPS)、中醫(yī)癥狀改善情況,并運(yùn)用SPSS21.0統(tǒng)計(jì)學(xué)軟件進(jìn)行數(shù)據(jù)分析,得出結(jié)論。結(jié)果1.(1)388例住院肺癌患者腫瘤相關(guān)性貧血發(fā)生率為48.97%,貧血半數(shù)以上為輕度貧血142例(占74.14%),中度貧血42例(占22.11%),貧血細(xì)胞學(xué)分類以正常細(xì)胞性貧血(占47.37%)和小細(xì)胞低色素性貧血(占37.89%)多見。(2)男、女貧血發(fā)生率分別為53.96%、36.36%;≤65歲年齡段貧血發(fā)生率46.02%,65歲年齡段貧血發(fā)生率53.09%。小細(xì)胞肺癌貧血發(fā)生率50.00%,NSCLC貧血發(fā)生率48.85%;NSCLC中腺癌和鱗癌貧血發(fā)生率分別為42.57%、59.10%。單一治療組患者貧血發(fā)生率42.50%,綜合治療組患者貧血發(fā)生率53.51%;中醫(yī)干預(yù)組患者貧血發(fā)生率45.74%,非中醫(yī)干預(yù)組患者貧血發(fā)生率57.55%。(3)從190例肺癌相關(guān)性貧血患者的治療組成情況看,貧血治療率為45.79%,采取輸血治療14例(7.37%),促紅細(xì)胞生成素治療5例(2.63%),補(bǔ)充鐵劑等24例(12.63%),中藥治療44例(23.16%)。(4)單因素分析顯示性別、病理類型、所采取治療方法與貧血發(fā)生相關(guān),年齡與貧血發(fā)生無關(guān)。2.(1)血紅蛋白值:治療組治療后血紅蛋白值為99.67±14.66g/L,與治療前91.33±10.49 g/L相比,有統(tǒng)計(jì)學(xué)差異(P0.05);改善貧血療效優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)KPS評(píng)分:治療組KPS評(píng)分治療后高于治療前,差異有統(tǒng)計(jì)學(xué)意義(P0.05);生活質(zhì)量改善情況優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(3)中醫(yī)癥狀:治療組中醫(yī)癥狀顯著改善率為74.29%,高于對(duì)照組的45.71%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論1.肺癌相關(guān)性貧血的發(fā)生率較高,抗腫瘤治療會(huì)增加貧血的發(fā)生,男性、老年、鱗癌患者更易出現(xiàn)貧血。肺癌相關(guān)性貧血治療率偏低,中醫(yī)是重要治療手段之一。2.健脾益腎方能有效提高晚期NSCLC合并輕、中度貧血血虛型患者的血紅蛋白值,改善臨床癥狀和生活質(zhì)量。
[Abstract]:1. through the case in 388 patients with lung cancer were retrospectively analyzed. The incidence and treatment status summary lung cancer related anemia, provide reference for.2. observation of Jianpi Yishen Decoction in the treatment of advanced non-small cell lung cancer for clinical treatment (Non-Small Cell Lung Cancer, NSCLC) the clinical curative effect of related anemia, combine traditional Chinese and Western medicine in the treatment of cancer related anemia to provide the basis. Methods 1. from January 2015 to December 2015 in Hubei Provincial Traditional Chinese Medical Hospital Tumor Hospital of lung cancer patients with a total of 388 Cases were confirmed by histopathological diagnosis and complete medical records, the incidence of hospital statistics in patients with tumor related anemia,.2. study of pathogenesis and treatment of anemia from January 2016 to late September 2016 NSCLC in Hubei Provincial Traditional Chinese Medical Hospital oncology clinic with light, 70 of patients with moderate anemia patients were randomized into the treatment group ( The combination of TCM and Western Medicine) and control group (Western medicine group), 35 cases in each group. The two groups of patients with the general situation and the value of hemoglobin (Hemoglobin, Hb) by statistical analysis, the difference was not statistically significant (P0.05). The control group took iron supplements, folic acid, vitamin B12 in the treatment of oral Mg (Iron Polysaccharide Complex Capsules 300, 1 times; daily Folic Acid Tablets 10 mg 3 times a day, oral; vitamin B12 tablets 25 g, orally 3 times a day). The treatment group in the control group treated with Jianpi Yishen Decoction, one dose a day, decocted in water to 300ml, two clothes, 6 weeks after.6 weeks on hemoglobin values in two groups after treatment observation, Karnofsky score (Karnofsky, KPS), TCM symptoms, and the use of SPSS21.0 statistical software for data analysis, draw the conclusion. Results 1. (1) occurred in 48.97% of 388 patients with cancer-related anemia in patients with lung cancer, more than half the number of mild anemia anemia in 142 cases (74.14%), moderate and poor The blood of 42 cases (22.11%), anemia with normal cytology cell anemia (47.37%) and microcytic anemia (37.89%) found. (2) male, female incidence of anemia were 53.96%, 36.36%; less than 65 years of age the incidence of anemia in 46.02%, 65 years of age, poor the incidence rate of blood 53.09%. in small cell lung cancer incidence of anemia was 50%, the incidence of anemia in 48.85% NSCLC; NSCLC in adenocarcinoma and squamous cell carcinoma incidence of anemia was 42.57%, single 59.10%. anemia occurred in 42.50% patients in the treatment group, combined treatment group patients the incidence of anemia in 53.51% patients; the TCM group the incidence of anemia in 45.74% patients in the intervention group, the non Chinese medicine the incidence of anemia in 57.55%. (3) in the treatment of 190 cases of patients with lung cancer related anemia composition, anemia treatment rate was 45.79%, blood transfusion therapy in 14 cases (7.37%), erythropoietin treatment in 5 cases (2.63%), the iron supplement in 24 cases (12.63%), Chinese medicine treatment 44 Cases (23.16%). (4) single factor analysis showed that gender, pathological type, and take treatment for anemia associated with anemia, age has nothing to do with.2. (1) value of hemoglobin: after treatment, the hemoglobin value was 99.67 + 14.66g/L, compared with before treatment, 91.33 + 10.49 g/L, there were significant differences (P0.05); improve anemia effect is better than the control group, the difference was statistically significant (P0.05). (2) KPS score: the KPS score of the treatment group after treatment than before treatment, the difference was statistically significant (P0.05); to improve the quality of life is better than the control group, the difference was statistically significant (P0.05). (3): the treatment of TCM symptoms group of TCM symptoms significantly improved rate of 74.29%, higher than 45.71% in the control group, the difference was statistically significant (P0.05). Conclusion: 1. lung cancer related anemia and higher incidence of tumor treatment will increase the incidence of anemia, male, older, more prone to anemia. Patients with squamous cell carcinoma of lung cancer. The treatment rate of anemia is low. Chinese medicine is an important treatment..2. Jianpi Yishen Decoction can effectively improve the hemoglobin value of patients with advanced NSCLC and mild to moderate anemia and blood deficiency, and improve the clinical symptoms and quality of life.

【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R734.2;R556

【參考文獻(xiàn)】

中國期刊全文數(shù)據(jù)庫 前10條

1 陳萬青;鄭榮壽;張思維;曾紅梅;鄒小農(nóng);赫捷;;2013年中國惡性腫瘤發(fā)病和死亡分析[J];中國腫瘤;2017年01期

2 石遠(yuǎn)凱;孫燕;于金明;丁翠敏;王子平;王長利;王東;王存德;王征;王孟昭;支修益;盧鈾;馮繼鋒;劉云鵬;劉曉晴;劉巍;伍鋼;李小梅;李凱;李恩孝;李薇;陳公琰;陳正堂;余萍;吳寧;吳密璐;肖文華;張力;張沂平;張樹才;楊樹軍;宋霞;林冬梅;羅榮城;單莉;周彩存;周宗玫;趙瓊;胡成平;胡毅;郭其森;常建華;黃誠;曾tD;韓寶惠;韓曉紅;郟博;韓穎;黃昱;;中國晚期原發(fā)性肺癌診治專家共識(shí)(2016年版)[J];中國肺癌雜志;2016年01期

3 馬軍;王杰軍;張力;石遠(yuǎn)凱;朱軍;王健民;陸舜;秦叔逵;王耀;;腫瘤相關(guān)性貧血臨床實(shí)踐指南(2015—2016版)[J];中國實(shí)用內(nèi)科雜志;2015年11期

4 王志鵬;劉巍;張陽;;肺癌化療相關(guān)性貧血形成特點(diǎn)及中醫(yī)辨證思路初探[J];山東中醫(yī)雜志;2015年09期

5 婁彥妮;陳信義;侯麗;李園;譚煌英;劉猛;賈立群;;癌性貧血的中醫(yī)證候與用藥規(guī)律分析[J];中華中醫(yī)藥雜志;2015年06期

6 張星星;李澤庚;;中醫(yī)藥治療肺癌機(jī)制研究概況[J];中醫(yī)藥臨床雜志;2015年04期

7 蘆殿榮;蘆殿香;殷玉琨;何生奇;王寧軍;于建華;柏大鵬;王芳;高音;王澤民;杜艷林;馮利;;復(fù)方阿膠漿改善惡性腫瘤患者生活質(zhì)量的臨床研究[J];云南中醫(yī)中藥雜志;2015年03期

8 曹兆平;代興斌;田劭丹;孫雪梅;;359例肺癌相關(guān)性貧血的中醫(yī)藥應(yīng)用分析[J];中藥藥理與臨床;2015年01期

9 袁紅;陸舜;;肺鱗癌靶向治療研究現(xiàn)狀[J];中國肺癌雜志;2013年10期

10 包永睿;王帥;孟憲生;楊欣欣;王瑩;;白茅根水提物對(duì)人肝癌細(xì)胞株SMMC-7721細(xì)胞周期及細(xì)胞凋亡的影響[J];時(shí)珍國醫(yī)國藥;2013年07期

，

本文編號(hào)：1657616